The origin, range, and structure of prions causing the most common human prion disease, sporadic Creutzfeldt-Jakob disease (sCJD), are largely unknown. To investigate the molecular mechanism responsible for the broad phenotypic variability of sCJD, we analyzed the conformational characteristics of protease-sensitive and protease-resistant fractions of the pathogenic prion protein (PrP Sc) using novel conformational methods derived from a conformation-dependent immunoassay (CDI). In 46 brains of patients homozygous for polymorphisms in the PRNP gene and exhibiting either Type 1 or Type 2 western blot pattern of the PrP Sc, we identified an extensive array of PrP Sc structures that differ in protease sensitivity, display of critical domains, and conformational stability. Surprisingly, in sCJD cases homozygous for methionine or valine at codon 129 of the PRNP gene, the concentration and stability of protease-sensitive conformers of PrP Sc correlated with progression rate of the disease. These data indicate that sCJD brains exhibit a wide spectrum of PrP Sc structural states, and accordingly argue for a broad spectrum of prion strains coding for different phenotypes. The link between disease duration, levels, and stability of protease-sensitive conformers of PrP Sc suggests that these conformers play an important role in the pathogenesis of sCJD. © 2011 Kim et al.
Kim, C., Haldiman, T., Cohen, Y., Chen, W., Blevins, J., Sy, M. S., … Safar, J. G. (2011). Protease-sensitive conformers in broad spectrum of distinct prp sc structures in sporadic creutzfeldt-jakob disease are indicator of progression rate. PLoS Pathogens, 7(9). https://doi.org/10.1371/journal.ppat.1002242